{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:15:14Z","timestamp":1769109314249,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007313","name":"University of Texas MD Anderson Cancer Center","doi-asserted-by":"publisher","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}],"id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We sought to determine the significance of minimal residual disease (MRD) relapse in patients with ALL after achieving MRD negative status following induction and consolidation therapy. Between January 2003 and September 2014, 647 newly diagnosed patients were treated [HyperCVAD\u2010based (<jats:italic>n<\/jats:italic>\u2009=\u2009531); Augmented BFM (<jats:italic>n<\/jats:italic>\u2009=\u2009116)]. Six hundred and one (93%) achieved complete remission (CR), and 546 (91%) became MRD negative. Fifty\u2010five patients [HyperCVAD\u2010based (<jats:italic>n<\/jats:italic>\u2009=\u200949); Augmented BFM (<jats:italic>n<\/jats:italic>\u2009=\u20096)] developed recurrence of MRD while still in morphological CR and are the subjects of this study. MRD was assessed by 6\u2010color (4\u2010color prior to 2009) multi\u2010parameter flow cytometry (MFC) at CR and multiple time points thereafter. Their median age was 44 years (range, 18\u201372 years), median WBC at initial presentation was 7.3 K\/\u00b5L<jats:sup>\u22121<\/jats:sup> (range, 0.6\u2013303.8 K\/\u00b5L<jats:sup>\u22121<\/jats:sup>) and median bone marrow blast percentage 88% (range, 26\u201398%). The median time to MRD relapse was 14 months (range 3\u201358 months). Forty\u2010four (80%) patients subsequently developed morphological relapse after median of 3 months (range, &lt;1\u201333 months) from detection of MRD recurrence. Treatments received after MRD positivity and prior to morphological relapse: 16 continued maintenance chemotherapy; 15 received late intensification; 9 allogeneic stem cell transplant, 9 changed chemotherapy, 6 no further therapy. Only six remain alive and in CR1 and nine are alive after morphological relapse. MRD relapse detected by MFC at any time after achieving CR is associated with a high risk for morphological relapse. SCT can result in long\u2010term remission in some patients. Prospective studies of long\u2010term MRD assessments, together with less toxic treatment strategies to eradicate MRD, are warranted.<\/jats:p>","DOI":"10.1002\/ajh.24629","type":"journal-article","created":{"date-parts":[[2017,1,4]],"date-time":"2017-01-04T23:00:46Z","timestamp":1483570846000},"page":"279-285","source":"Crossref","is-referenced-by-count":36,"title":["<scp>S<\/scp>ignificance of recurrence of minimal residual disease detected by multi\u2010parameter flow cytometry in patients with acute lymphoblastic leukemia in morphological remission"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1670-6513","authenticated-orcid":false,"given":"Naveen","family":"Pemmaraju","sequence":"first","affiliation":[{"name":"Department of Leukemia University of Texas, MD Anderson Cancer Center Houston 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